North American Registry of Midwives (NARM) Practice Exam

Which factors can lead to indigestion and heartburn during pregnancy?

1. Increased estrogen levels

2. Displacement of stomach and intestines by the growing uterus

3. Low fiber intake

4. Increased physical activity

The correct answer is: Displacement of stomach and intestines by the growing uterus

The displacement of the stomach and intestines by the growing uterus is a significant factor that can lead to indigestion and heartburn during pregnancy. As the uterus expands, it pushes against the surrounding organs, including the stomach. This pressure can disrupt the normal positioning of the stomach, making it more difficult for food to move through the digestive system effectively. As a result, these changes can cause feelings of fullness, discomfort, and an increased likelihood of acid reflux, contributing to heartburn. In contrast, while increased estrogen levels may influence various aspects of digestion, they are not directly responsible for the mechanical pressures in the abdomen that result in indigestion and heartburn. Low fiber intake can also affect digestion, but it primarily influences bowel regularity and may not be the leading cause of heartburn in pregnant individuals. Increased physical activity typically aids digestion and can potentially alleviate symptoms rather than exacerbate them. Thus, the physical displacement caused by a growing uterus is the most relevant and direct cause of these symptoms during pregnancy.